摘要
目的探讨维奈克拉(VEN)联合阿扎胞苷(AZA)对难治/复发性急性髓系白血病(R/R AML)患者免疫功能及血清血管内皮生长因子(VEGF)水平的影响。方法选择收治的68例R/R AML患者,采用倾向性评分匹配法按1∶1比例进行匹配,匹配后得到研究组(VEN联合AZA)34例和对照组(安慰剂联合AZA)34例,均采用1个标准化疗方案持续治疗。比较两组总缓解率和化疗前后免疫功能指标、血液指标、血清VEGF水平及化疗期间不良反应发生率;比较两组随访12个月的总体生存率(OS)和无事件生存率(EFS)。结果研究组R/R AML患者总缓解率为52.94%,显著高于对照组的29.41%(P<0.05);化疗后研究组CD3^(+)、CD4^(+)和CD4^(+)/CD8^(+)水平均显著高于对照组(P<0.05);研究组骨髓原始细胞比例和VEGF水平则显著低于对照组(P<0.05);研究组化疗期间不良反应发生率为55.88%,与对照组(35.29%)比较无显著差异(P>0.05);研究组化疗后12个月OS为76.32%,与对照组(71.42%)比较无显著差异(Log-Rankχ^(2)=1.001,P>0.05);研究组EFS为69.76%,高于对照组的40.74%(Log-Rankχ^(2)=4.313,P<0.05)。结论VEN联合AZA治疗可改善R/R AML患者免疫功能,降低血清VEGF水平,安全性好,耐受度高。
Objective To explore the effects of venetoclax(VEN)combined with azacitidine(AZA)on immune function and level of serum vascular endothelial growth factor(VEGF)in patients with relapsed/refractory acute myelogenous leukemia(R/R AML).Methods According to propensity score matching method,68 patients with R/R AML were divided into the study group(34 cases,VEN^(+)AZA)and the control group(34 cases,placebo^(+)AZA),and all were continuously treated with the same standard chemotherapy regimen.The total remission rate,immune function indexes,blood indexes and serum VEGF before and after chemotherapy,incidence of adverse reactions during chemotherapy,overall survival(OS)and event-free survival(EFS)within 12 months of follow-up were compared between the 2 groups.Results The total remission rate in study group was significantly higher than that in the control group(52.94%vs 29.41%,P<0.05).After chemotherapy,levels of CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)in the study group were significantly higher than those in the control group(P<0.05).The proportion of bone marrow blast cells and VEGF level in study group were significantly lower than those in the control group(P<0.05).The difference in the incidence of adverse reactions between the study group and the control group was not statistically significant during chemotherapy(55.88%vs 35.29%,P>0.05).At 12 months after chemotherapy,difference in OS between the study group and the control group was not statistically significant(76.32%vs 71.42%,Log-Rankχ^(2)=1.001,P>0.05).EFS in the study group was higher than that in the control group(69.76%vs 40.74%,Log-Rankχ^(2)=4.313,P<0.05).Conclusion VEN combined with AZA can improve immune function and reduce level of serum VEGF in R/R AML patients,with good safety and high tolerance.
作者
刘苏慧
王瑞娟
段丽娟
LIU Suhui;WANG Ruijuan;DUAN Lijuan(Nanyang Central Hospital,Nanyang,473000)
出处
《实用癌症杂志》
2024年第10期1736-1740,共5页
The Practical Journal of Cancer
关键词
维奈克拉
阿扎胞苷
难治复发性急性髓系白血病
免疫功能
内皮生长因子
Venetoclax
Azacitidine
Relapsed/Refractory acute myelogenous leukemia
Immune function
Endothelial growth factor
